HJAR Sep/Oct 2022

DIALOGUE 18 SEP / OCT 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   Editor They spend more time, so they make less money, kind of situation. Smyth Well, that gets back to what I would if I could change in healthcare. It would be to incentivize for outcomes and not for these process metrics that may or may not reflect the actual outcome that we’re trying to achieve. Editor That makes sense. I kind of went off on a little rabbit hole, and I was just curious from your perspective on that, because I hear it. I had a university PR person tell me, “We need more black doc- tors,” and my question was, respectfully, “Why don’t we just get more doctors who are good?” Smyth Yes, I’ll share that. If you look at the number of black men that are in medical school across the United States, the abso- lute numbers have really not changed since I was a medical student. There’s something wrong with that system. Editor I’ve taken an hour of your time, and I really appreciate it. Is there anything else that you wish that you would’ve been asked? Smyth Well, one of the things that we didn’t really touch on is what some of the predic- tors of physicians practicing in rural loca- tions are. It was occurring to me as you were talking about our competing with urban areas. We know attracting students from rural locations is important, so that’s a big effort that we have when we’re accepting students — thinking geographically around fromwhere they’re coming and what they’re expressing interest in doing. Are they inter- ested in returning to their communities?An important factor is exposure to rural medi- cine early in medical school, and I think we did that well through regional programs and then residency location. One of the things that we really do need to brag about are our regional programs, and the percent of the residents in our family medicine residency programs across our regional campuses that are staying either in the community or practicing in rural locations is really impressive. Editor I’m in a rural area. The physicians in these areas wear so many different hats and are so valued for what they do. I mean, you can really make an impact, and you have to be trained in a lot of different ele- ments that a city doctor might not. You send them off to a specialist when nec- essary, but the economics of going to a specialist somewhere else is expensive, it’s time consuming, it’s hard. These doc- tors working in these rural communities, they’re special. Smyth Yes, and it takes a very particular mindset, somebody who has the confidence that they can manage, and that have good, sort of active learning skills. And you’re right. It’s a different practice of medicine as opposed to a specialist that is guided by a lot of fundamental knowledge in a very par- ticular area — somebody who has the con- fidence, really, to tackle a whole bunch of different types of conditions. Editor What makes someone want to go into rural medicine? Smyth Again, the things that we know — because there’s some literature around what has been identified — are coming from a rural area, being exposed to rural practice during medical school, and then your train- ing location as a resident. Editor Thank you for the time and for shar- ing your vision. Smyth I look forward to partnering and working with you on lots of important things. Editor My gosh, you’re setting the future. Good luck. You have a big job ahead of you, an important one. If we can help you, let us know. n “Inmy own field of cardiology, we have a real issue in terms of the number of women that are in the field. We are ranked third for the least women. I find it impossible to believe that there aren’t women who are every bit as capable of delivering heart care as men. There are systems issues that I think have prevented women from coming into the field that fundamentally need to be addressed.”